Friday, 29 January 2010

On Wednesday, I got what seemed like a great email from the research administration at the hospital I work for. 250,000 kr. awarded to my PhD project so I could by the retinal camera, computer and imaging software I need. But, oh, there was not enough money for my salary, starting in, um 5 days. The hospital I work for recently learned they had to cut back on spending. So I could buy all the equipment I could dream of, but I just couldn't expect to actually work for the hospital anymore. Well, isn't that nice?

I went to the head of the Ophthalmology Department, who, by the way, is the best type of woman anyone could hope to work for: funny, honest, caring. Anyway. She felt terrible. It was, after all, the department that had asked me to start this huge project. It is by the way a population study of 6500 adults. So she scrambled to find some paid work for me. I ended up with a little under part time work for next month. I am really hoping that all of the funds I have applied to recently will result in me getting my salary paid for after this month.

But in the meantime, I am a free woman! Well, sort of. I can use this month to get into great shape, learn how clean a cook (these have always been overlooked in my insane busy schedule), work on research on the side whenever it pleases me, read some good books, go to yoga more, etc. Plus every day this past month has been a huge struggle to drop off and pick up the kids on time, not to mention taking them to their multiple weekly activities. SR working an hour away has really made life more difficult.

Ahh, but now things look a bit different. So many possibilities. What should I do with my time? I am starting by going to the dentist. No better way to start a month than with a teeth cleaning. Life is good. I don't know what is coming next, but I am happy.

Running Song of the Day: Memphis by PJ Harvey (yes, thanks again, Danni... this was also one of my old favorites!)

Sunday, 24 January 2010

My life is filled with routines. When I am stressed and running short on time or happy and under no stress at all, I find comfort in doing the same things over and over. This does not help my training or my recovery time or my health (or really any other aspect of my life). I have thus found ways to make variety itself part of my routines. I have not always been successful at implementing them.

1. Running on uneven surfaces. I can run longer and return to running faster after injury if I avoid asphalt. This is of course a tradition that has been promoted for a long time in Chinese culture, although in the slightly different form of walking barefoot on uneven surfaces. This involves a transfer of energy between the feet and the earth. And if that doesn't excite you, you also work different muscles, which helps to avoid overuse injuries.

Here is a path for walking barefoot on at Lan Su Chinese Garden in Portland.

A practical problem is it is hard to run with a baby jogger on snowy trails, so I find myself often back on the sidewalk.

2. Yoga. I try to make time for it, because it works. I had a terrible SI joint-related muscle strain in medical school. I went to the doctor and was given an expensive, pointless bone scan, Vioxx, which had tons of side effects and was told I was too thin. Thanks for the help. I could not run for 6 months. Then I started going to yoga and it became clear how tight my muscles were and what an inability I had to just sit and relax. While practicing yoga regularly, I avoided injury for years until I became pregnant (again the SI joint). I can clearly feel the difference when I run, if it has been a while without sun salutations and other hip stretches. I went to three yoga-tai chi classes following the marathon, which did wonders for my SI joint and hip.

3. Fish and vegetables. Okay so these aren't Asian per se, but they're more Asian than Western. I have been good at eating these regularly. But wow, did I fail miserably these last two weeks. Here is a little honest insight into what an obsessive compulsive lady might eat when busy with call and research. The following is a list of everything I ate during the first 10 days after the marathon: rolls, chocolates, flødeboller (cream-filled chocolate), coffee, diet soda. No, that was not one day or one morning, but 10 straight days. Gained no weight, lost no weight and felt surprisingly fine. One really can live on just bread and water... for a while. It's just good it takes around 3 months to develop scurvy.

I started eating normally again on Friday, thanks to the fact we had two of Natali's friends over for dinner.

It's good someone here likes to cook. :)

Today I was finally fully recovered. I went on a great 3 hour run (first 1.5 with the baby jogger, second on snowy trails) and then 45 flights of stairs with SR.

As long as I'm praising Asia. Check out this graph (sorry the writing is so small):

That is money spent per person on health care to the left and life expectancy to the right. The thicker the line, the more doctor visits per person. If you can look past the absurdity of the US, take a look at Japan. One has to wonder if it is simply genetics and if not, what exactly it is they are doing right.

Running song of the day: Counting Bodies Like Sheep to the Rhythm of War Drums by A Perfect Circle (good one, Danni! Very different than what I usually like)

Wednesday, 20 January 2010

Men and women: they are biologically different, of course. They run races differently so why wouldn't they also recovery differently? Seems intuitive, but I can't find that this has been looked into much, if at all, scientifically before.

I was inspired to write this post after reading emails and comments from many of you, then looking into it further and noticing a pattern: men tend to get injured during races, women 1-2 weeks after.

Why is this?

Let's look at women first: they are more flexible than men, due to estrogen, so this in itself helps prevent injury during the race itself. Plus, women tend to be extremely good at noticing warning signs from their bodies. This helps prevent them from pushing themselves to the point of injury.

Men are more likely to go all out and either get injured or make it through the race and do well. After a marathon or ultra marathon, a typical man's response would be "I just ran a marathon, so I'd better not run for a while."

Whereas women seem to think they can just return to their normal exercise routine. It is hard to say if this is soley the result of pyschosocial factors such as the need to stay thin and the need to prepare for the next race, or if there is also a biological reason for this train of thought.

Here is my experience vs. SR's after our last marathon: During and shortly after the race I felt good. The very next day, I went out for a 20 minute run without any specific pain, but just a general fatigue. Over the next few days, I ran between 20 minutes to an hour, slowly, just trying to recover. But as they days went by, my right hip bothered me more and more. Yesterday, it was to the point that I couldn't walk without a limp because my right leg had been pulled a good 2 cm shorter than the left due to muscle tightness in my right lower back and hip. It is so painful that I have trouble sleeping if I don't have a heafty dose of anti-inflammatory in my body.

SR on the other hand didn't run at all for 4 days after the race. After marathons or ultras he is so sore that he can barely walk the next couple of days. Now it has been 10 days since the race and he is back to his normal running routine without any injuries or pains to speak of.

I was moved by Marie-Aline's story of running her debut marathon in 3.10 and feeling great, returning to hard training a week later and ending up with an ankle injury that gradually worsened and left her unable to train for 18 months!!

Another small amount of evidence comes from the Trans-Alpine race where women's teams classically start out doing well, but by the end of the week, a much smaller percentage of women's vs. men's teams are able to complete the course (due to injury). And I do not believe this was caused by a lack of training.

The importance of pre and post race nutrition as well as adequate rest has also been raised many times. But I struggle to find evidence or good guidelines.

My informal research has led me to believe that men and women should follow different guidelines, but I am sadly far from proposing any due to lack of evidence. I look forward to all of your thoughts on this subject.

No running song today... but I will give a shout out to Danni, who sent me some running music, which I am so excited to hear :)

Wednesday, 13 January 2010

When I was 21, I ran a lot, but wouldn't consider running a marathon because I thought it was "too long to be healthy". But at age 25, I found myself running my first marathon and loving it. Since that time, I haven't spent much time considering whether running marathons or longer races is actually healthy. Let's face it, when you enjoy something so much, you don't tend to look at it objectively.

But on Monday, the day after we ran the Kalundborg Winter Marathon, I found myself unable to think straight. Patients and colleagues alike would ask me questions or give me information and I would stare at them as if they were a teacher from Charlie Brown. Normally I would attribute behaviour like this to low blood sugar or lack of sleep. But I am certain neither of these were the case. And my boss said I looked ill and that she was concened about me. Despite being a physician, I find myself unable to explain these untoward effects other than attributing it all to "exhaustion".

Here I am looking kind of dead after the race:

To determine whether or not a marathon is "healthy", one should probably consider the immediate, secondary and long-term effects it has on the body.

1. Short-term health effects:

It is hard to find many short-term health benefits. There is of course that rush of adrenaline and another benefit for most people is burning calories. Negative effects on health include muskuloskeletal injuries, hyponatremia (from drinking too much water), heat stroke, kidney failure (seen rarely in ultras) and the extremely rare but feared sudden cardiac death. In looking at studies of people who die from heart problems in a marathon, these are exclusively people with underlying heart conditions, whether they know it or not. There is also damage and death of cardiac muscle cells during a marathon, shown in multiple studies by a rise in troponin in the blood after a marathon, as one sees with a heart attack. I'll get back to the meaning of that long-term in a bit.

A great study in the British Medical Journal (BMJ. 2007 Dec 22;335(7633):1275-7.) looked at large marathons in cities all around the world and found that one is more likely to die of an accident in the city outside of the race than to die during the race. I think that helps put the issue of marathon safety in perspective. And one of the best things about marathons may be that they result in so many road closures, that numerous traffic-related deaths are prevented.

I have also never come across serious problems pregnant women have had while running marathons. But you can bet your life savings that when the first pregnant woman does make the news for a marathon-related health problem, pregnant women all over the world will decide not to run at all when pregnant.

2. Secondary effects:

Not only does one feel tired, but there is quite a bit of evidence that one's immunesystem functions abnormally for up to 72 hours after a race.

2. Long-term health effects of a marathon:

First of all, it is extremely hard to do good research on the long-term health effects of a marathon, when marathon runners tend to be healthier people in the first place.

As far the long-term effects on the heart, no concensus has been reached. All studies are small and they have found conflicting results (read this article in the New York Times for more info http://well.blogs.nytimes.com/2009/09/30/phys-ed-how-do-marathons-affect-your-heart/).

Anyone else have thoughts on the subject?

Here are so more pictures from Kalundborg Winter Marathon and a video clip of the marathon from Danish tv:

Sunday, 10 January 2010

As we drove to drop off the kids at their grandparents' in Copenhagen, we almost landed in the ditch a few times because of the wind gusts, which had blown snow up onto the highway. The wind was a steady 35-40 miles per hour and stronger at times. Not exactly what most people would consider ideal conditions for running a marathon. But I was SO excited. This was going to be something I had never experienced. I was just hoping they wouldn't cancel the race.

I figured I could pretty easily run a PR today. I knew the route and felt good despite 3-4 hours of sleep (I don't know why I still get so nervous before races). But the wind and the colder temperatures than last year changed the story a bit. SR was also running the marathon this year. He had run the half last year with the baby jogger. Thank God there was no baby jogger involved this year.

At the start line, I saw Britta Karlsson, who had handily beat me in the Albertslund 6 hour run this past fall. I now figured I wouldn't win or PR, but I was just so excited to run.

The run started out in snow and then went out onto roads.

There are a bunch of steep hills at the beginning, but the wind wasn't too bad yet. I kept an even 7:45 minute/mile pace and was just trying to keep myself from running faster. I ran with a bunch of guys and could not see any females behind me. Strangely, I could see SR ahead of me for about the first 6km. Man, he was starting out slowly!

At about 9 km, we took a turn down a deserted road towards the ocean and the wind was so strong that people we nearly being knocked down (okay, mostly me). It was like when you try to run in a dream but you can't move. It was so beautiful with the huge whitecaps on the dark ocean and the horses on the farms with their manes blowing in the wind. I pretended it was my first moment on Earth and that I'd never known anything but the feeling of running as fast as I could into a headwind. Soon we turned a corner, and the wind came off the ocean from the side, but it became even harder to run. I found a group of guys to run behind and things got a little easier. Soon we were out of the really windy section and I talked with the other runners around me. I ran for a while with a guy who had run 30 marathons last year.

At about 13 km, I was running at my comfortable 7:45 min/mile again. I love having the Garmin on. And I stopped for hot chocolate at an aid station. I will just comment that hot chocolate is a great sports drink for winter. Calories, electrolytes, warmth...

I came through the first half marathon in 1:43, thus winning the women's half marathon! The woman who came in right behind me was sprinting to beat me, but little did she know I was doing the full marathon and she'd get her prize money after all.

Now I just needed to do the whole thing again. Sadly, the wind hadn't let up and my legs were tired of battling it. I ran the first half of the second half marathon in a hour!! I was more than a little disappointed. But once I got out of the wind again, um, I got a second wind, no I won't say that. I'll just say, I felt much better. The people on the sidelines were really cheering me on. I was glad they knew I was first woman (and that I wasn't mistaken about my place). I then realized on was on pace for a PR. I kept my pace at about 8 min/mile and had some good music on (Thanks, Cliff!!). My comfortable marathon running pace has definitely gotten faster. The last part of the race is on snow trails though a wooded area. Man, was I excited. I came in at 3:37, beating my previous PR by two minutes (on the same course last year and at the 6 hour run).

After talking with a few people afterwards, it seems we should subtract about 20 minutes from our time today to compare it to a warmer, flatter, less windy race. Fun to think of running a 3:17! All I can say is the intervals and tempo training the last two months have really helped. Plus I ate a ton yesterday and I think that helped, too.

Britta also ran a great race and came in just 9 minutes behind me. It is hard to say if I have become faster or if it was the race today was just a completely different type of race than the 6 hour race in October.

SR also had a great race with a time of 3:02, also a PR for him (we don't tend to run normal marathons), and he came in second. It was also his birthday yesterday, so it was a good little belated present. He apparently passed the whole field of top men in the last 10 km. He was beaten by Ole Karlsen, a famous runner in Denmark, affectionately known as Ultra Ole.

It was an awesome experience and I would recommend this race to anyone who wants a winter running challenge.

Here is one happy couple.Hey, and the winner gets 400 kroner (that's about $80) and second gets 200 kroner.

I am ashamed to admit that my favorite running song of the day:

Watcha Say by Jason Derulo (I hate the way he samples Imogen Heap. I hope Imogen Heap got some good consolation for it. But I just LOVED running to it)

Thursday, 7 January 2010

As I experience a mega taper before the Winter Marathon on Sunday, I have decided create a list of Danish things that that have made my life a little happier.

1. The Brio Wagon

This is perfect for babbies/toddlers starting to walk. The Lorax gathers all of the most important items from the house and walks around with them.

2. The kitchen waste basket

You never need to wonder where the garbage is in a Danish kitchen. There is always a wire contraption attached to the door under the sink. A trash bag fits easily in and pulls easily out of it. It's genius.

3. The Danish Sauna

Ha ha. I love that picture. 80-100 C, gender-specific, no swimsuits allowed. It is THE best way to dry off, warm up and relax after a swim. (sorry, I wrote "unisex" before thinking it meant "one sex". I must admit I tried a nude sauna with both sexes in Italy and it was more than slightly awkward. No males over 5 in the ladies' saunas in Denmark, so yes, The Lorax can join me.)

4. The flyverdragt.

Literally the "flight suit". This is a winter must for ALL Danish children under 16, and many (too many?) adults. Okay, honestly, I wouldn't mind one.

5. Barbapapa

This is actually a French series of books, but the characters are omnipresent in Denmark. These creatures speak to The Lorax on a level I as an adult can't comprehend. But, MAN!, he loves these shapeshifting guys. Parents, do yourselves a favor and buy a book or two.

6. The dish brush

I can't even remember how I used to wash dishes. If you haven't converted to a dish brush and a bowl with soap water, you should really give it a try.

7. Gummistøvler (rubber boots)

Why put up with wet feet? Children are not even allowed in school if the don't have a pair. I bought Step-daughter a pair that resembled gummistøvler because they were out of the authentic ones and they said she couldn't come to school the next day if I didn't buy the real ones that night. First rule of parenting in Denmark: never do anything that hinders your child from being outside.

8. Running Tights

Okay, I've mentioned it before, but they make running much more comforatable. Loose running pants are bordering on illegal here.

9. Squash Light

The BEST diet orange soda.

10. The dyne

A personal comforter to be used without a sheet. It's beautiful. Easy to make the bed. No fighting over blankets.

Wednesday, 6 January 2010

I thought it was time I let you all in on what a typical day in my life is like...

Yesterday I woke up at 6:45. SR had already left to take a train to Herlev. I took a lanzoprazole, ate a couple flødeboller, drank some coffee, and wrote a hurried email to a couple of Wisconsin friends who are visiting Denmark for the Copenhagen Marathon. I then walked by step-daughter's room and sang the song "Gotta get up! Gotta get up!" as I do every morning.

She wanted Nutella on toast for breakfast, as did the tired Heed, Lorax. Then I changed, washed the Lorax and we gathered everything we needed for the day. We headed down to the car by 7:30. Normally we would all bike, but in so much snow, I feel scared riding a bike with the child seat on the back. I know. I'm a wimp. But I've fallen a couple times with The Lorax on already.

They were safely off to school and dagpleje, when I realized I was running late. There was just too much traffic and Danes don't believe in salting roads, so everyone was driving much slower than usual. Scared, I parked illegally and ran out of the car in my huge black jacket and short sleaved white hospital garb. Oh, no, I had forgotten my white coat! Shit! My lens, my pens, my dictaphone...

I went into the morning meeting and all was normal for a few moments. I set out to move the illegally parked car and realized I had lost the car key. So I decided to run home in the white scrubs to get my white coat. Good thing I am the fastest female ophthalmologist in Næstved.

Thankfully, my first patient had cancelled. The rest of the morning consisted of examining patients to see if they were appropriate candidates for cataract surgery, taking various measurements of their eyes, testing their vision and examining their eyes.

At our lunchtime meeting, everyone tried to help me find my keys and I finally located them in the snow on the lawn in front of the hospital. I normally eat with a few colleagues, but they had an "overlæge" meeting, so I bought a tuna sandwich on rye bread and tried to fix an application for ph.d. money, which I had sent in the wrong form.

At the end of the day, I got the baby jogger and ran 2 miles though town as quickly as I could to pick up The Lorax. I almost took down an old couple and the wife yelled "Det må man ikke!". I got the Lorax and he enjoyed some string cheese on the way to get Step-daughter. He said "wow!" a number of times, as he always does, anytime he sees something new on the route. I then forced step-daughter into a running race home. We gathered food, diapers, a present for the hour drive to Copenhagen to meet SR, and his brother's family, who had just had a baby.

The baby, Ayla, was just perfect and adorable. SR had ordered personal pizzas for everyone but me. Good thing step-daughter was willing to share a slice as I was starving. I wasn't mad though, because SR had agreed to let me swim in the 50 meter pool in Gladsaxe while his parents watched the kids.

I had the most wonderful swim of 15 laps and did it so quickly that I had some extra time to do my new favorite stroke: swimming on my back holding a kickboard over my head. What a great ab workout!!

In the sauna I talked with one of the girls from the high school team who had been swimming next to me. Their coach had said to them that 50 meters in 38 seconds was too slow! Wow, that's booking it. I wish I would have learned to swim as a child.

So life was good and SR came to pick me up with the kids. He then got understandably mad about the fact that it was so late. I always lose track of time in the sauna. Then he got out of the car to drop off his bike at the Glostrup train station. Step-daughter then confided in me: "He's only angry because I did something wrong" (this was of course all in Danish). "What did you do?" I asked. "I got mad when Rebecca (her cousin) got a barbie doll and I didn't". Kids are so wonderful. I didn't care what she did. I loved her at that moment. The Lorax said "Papagøje" (parrot) as he sometimes says when he just needs something to say. The rest of the ride home was fun.

When we got home, I had to go send a document from the ph.d. office and then I accidentally locked my keys and SR's bike key in the office. It's not easy being married to Sea Legs Girl. But SR eventually found another key to the bike and went to bed, so he could get up early again for his now hour and a half (!) commute.

I tried to put The Lorax to bed, but he wanted his usual half an hour of playing piano, drawing and reading before bed. It was 11 pm, but who can blame him? So I stayed up with him, because I love that time, too.

Okay, so it is obvious my times correlate directly with what I weigh. And I was considering giving up on my training schedule (intervals once a week, tempo once a week and long run once a week, swimming +/- yoga on the rest days), which I have come to love over the past 2+ months, and just concentrating on losing weight.

But the thing is, the last race I listed was yesterday and it was in snow, icy trails, 17 degress F (- 8 C) and with some steep hills. This was the Novo Nordisk Bagsværd Sø Rundt. All the other races were in fairly warm weather. SR and I estimated that around 2 minutes should be taken off of our times due to the conditions to compare it to other races. In that case, I had a relative PR of 40:40 yesterday and was not at my lightest weight. I also have to say, the race yesterday felt effortless, more like a tempo run. I definitely could have pushed it a bit more had a female been close by. Should I admit the training is working?

I took first woman and SR took 3rd with a time of just over 36 minutes. He just barely lost to two of his old running friends, who he hadn't seen in years.

Saturday, 2 January 2010

I'm sending the cd's with running songs to everyone who has requested them so far on Monday, but have to say I can't offer any more! I thought I could just offer free cds for all eternity, but when I went to Bilka today to buy some blank cd's, I was astonished to find that 50 blank cd's cost $50 (250 kr)!! Luckily I had a huge stack of blank cd's from the US, otherwise I never could have never offered running song cd's in the first place. It will have to go on the list of things to buy when we are in vacation in the US.

Thanks to everyone who wrote requesting the cd's and I'm sorry to everyone who missed out.

Yesterday I ran 4 x 2 mile intervals in amazingly cold weather for Denmark (-6 C). It was just beautiful. The cold from Wisconsin must still be in my bones, because the temp felt very comfortable. Tomorrow we are running a 10k around Bagsværd Sø. Next weekend: Kalundborg Marathon. And hey, I lost 2 lbs over Christmas break, so I'm hoping for some fast times.

Running Song of the Day: Just Breathe by Pearl Jam (thanks to Minnesota runner, Kurt for his list of best albums from 2009)

Hello from Rude Skov

Photo by Stine Sophie Winckel

...

My name is Tracy. I am a physician scientist from the USA, living with my husband and two young boys in Denmark. I work as a post-doc fellow at Næstved Hospital. I have a scientific interest in vision loss, vision loss during exercise, exercise, running during pregnancy, MAF training as well as nutrition and health for athletes. I also have a love for music, physics, statistics, cycling, yoga, cross-country skiing, bla bla bal.

I was a member of Team USA at the IAU World Championships in Ultra Trail Running in 2013 in Wales. I am now training to run with Team Denmark at the IAU World Championships in Annency, France in May 2015.